It is important to know what the symptoms and causes of a calcaneal spur are, since it must be treated in time, to avoid important complications such as plantar fasciitis that causes disability and prostration.
The heel spur is nothing more than a bulge on the heel caused by the accumulation of calcium in the calcaneus bone. Due to the constant contact with the skin and nerve fibers, the presence of the spur generates pain, compromising the stability and gait of the patients.
It is estimated that 10 out of 100 people will develop foot pain in their lifetime and that 25% of these pain are caused by the presence of a heel spur.
Studies have shown that it is more common in women than in men, probably due to its relationship with footwear and they are mostly diagnosed after 30 years of age, with a higher incidence in the population over 60 years of age.
Heel spur symptoms
The characteristic symptom of a calcaneal spur is pain in the foot located in the lower and posterior area of the heel that is accentuated when resting the foot, putting on shoes and / or walking. The pain can be intermittent or chronic and is stabbing or burning.
One of the complications of a calcaneal spur is plantar fasciitis, which is the alteration in one of the structures that covers the bone called the deep plantar fascia, which generates more pain and can cause redness of the heel skin. Other symptoms are limitation and gait disorders.
Risk factors for developing a heel spur
The calcaneal spur can be seen in the entire population; however, some people are more likely to suffer from it. These risk factors are:
• Older adults, as tissue degeneration occurs due to age and this type of injury is more likely to develop.
• People who are overweight and obese, due to the constant weight to which the feet are subjected.
• Spending long periods of time on your feet.
• Physical activity such as jogging and running.
• Flat and short feet.
• Use of uncomfortable footwear.
Upon physical examination, an orthopedic surgeon will evaluate the sore spots on the heel and the patient's gait. The diagnosis of a heel spur is made by a plain X-ray of the foot.
An anteroposterior and lateral standing X-ray is usually requested, showing a bone formation in the shape of a hook located at the level of the heel.
Occasionally, other more specialized studies such as nuclear magnetic resonance can be requested, especially to reveal structures neighboring the calcaneal bone such as muscles, ligaments and skin and to rule out other differential diagnoses.
While most people with chronic foot pain suffer from heel spurs or plantar fasciitis, the rest should have a thorough examination to rule out conditions such as ankylosing spondylitis, Charcot arthropathy associated with Diabetes Mellitus, Seronegative arthritis (formerly known as Reiter's Syndrome), osteoarthritis or rheumatoid arthritis.
It is necessary to know that, if the entire population is X-rayed, at least 15% will have a calcaneal spur without showing any symptoms. Therefore, it is necessary to know what the symptoms and causes of heel spurs are in each patient, so that the orthopedic doctor indicates the treatment to follow.
The initial treatment is aimed at the patient improving their posture and exercise habits, resting their feet for a longer time, avoiding high-impact exercises and changing their footwear for a more comfortable one. If these recommendations are not enough, the doctor will prescribe anti-inflammatory analgesics, physical rehabilitation, local cold therapy and, on occasion, may perform corticosteroid infiltration of the foot (for example, betamethasone).
If with this treatment the patient does not improve after 6 months, the orthopedic doctor will indicate a corrective surgery, which consists of removing the inflamed tissue specifically the deep plantar fascia through a surgery called plantar fasciotomy. In Europe, there is a tendency to indicate radiotherapy in some cases of calcaneal spur that does not improve with the use of conventional treatment.
In general, if the recommendations are met, the calcaneal spur has a good prognosis, being better in those patients who lose weight and change their footwear.
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